2004 Salary Survey Results

Go beyond nursing to build your employee health career

Salaries stay flat as EHPs reach plateau

How do you make the most of your job — and your career — after a long tenure in the nursing profession?

Go beyond your nursing experience and think in a businesslike way, create value for your organization, and align your goals with those of the hospital, employee health experts say.

"I’ve seen many nurses who have been in these roles for many, many years," says Arlene Guzik, MSN, ARNP-BC, who taught a workshop on "Maximizing the Value of Your Occupational Health Program" for the American Association of Occupational Health Nurses in Atlanta.

"They have not changed with the times. They continue to provide the same services they provided, the same way they provided them, many years ago. They’re seen just as a nurse," says Guzik, who is director of clinical services at the Lakeside Occupational Medical Centers in Largo, FL, and president of the Florida State Association of Occupational Health Nurses.

Instead, employee health nurses need to demonstrate "effectiveness beyond the clinical effectiveness," she says.

The 2004 Hospital Employee Health Salary Survey reveals the challenge that employee health nurses and managers face. About 20% of respondents reported they received no raise in the past year, while only 10% reported flat salaries in 2003. HEH analyzed the responses from 249 employee health professionals around the country. Most of them (73%) work at nonprofit hospitals, and more than half (56%) are located in a medium-sized city or rural area.

Those who received a raise were most likely to get just a modest one; 46% reported receiving raises of 1% to 3%. Many respondents may have reached a ceiling after years of service at their hospitals. About 50% were 51 or older, and 63% have worked in health care for 25 years or longer.

In many cases, employee health nurses may be stuck in a middle ground. They don’t receive the special incentive bonuses given to nurses who work in clinical care, yet they don’t have the title and salary of a department manager, says Denise Strode, RN, COHN-S/CM, executive president of the Association of Occupational Health Professionals in Healthcare, based in Wexford, PA.

"A lot of times you are functioning as a manager because you have the full responsibility of the program, but if you aren’t supervising anyone, you can’t be called a manager," says Strode, who is clinical case manager at the OSF SFMC Center for Occupational Health at Saint Francis Medical Center in Peoria, IL.

What can you do about that? "I would remind everyone to look at their job description and have input into that," she adds. "I rewrote mine and put as many action and managerial type words [as I could]." That didn’t translate into an immediate raise for Strode, though she felt better having an action-oriented position.

She later became a case manager and had another opportunity to write her own job description. Because a case manager is on a higher pay scale than an RN, Strode has a higher earning potential.

The HEH Salary Survey found that 52% of employee health nurses earn between $40,000 and $60,000. By contrast, most employee health managers (53%) earn between $60,000 and $80,000. The highest paid employee health professionals work in suburban areas and live on the West Coast.

Getting a raise may be difficult in lean times for hospitals. But you can enhance your visibility and your value to your organization — and eventually better pay may follow, employee health experts say. Here is some of their career advice:

Conduct an organizational assessment.

"We really have to step back and do a careful analysis of what we hope to accomplish and look at it strategically so we then can demonstrate positive outcomes," says Guzik. You want to know who the important players are in the organization. Analyze costs, including the costs of the employee health service, workers’ compensation claims, and regulatory compliance. "Sit back and develop the strategic goals you wish to accomplish with the partners who will help you accomplish those goals," she says.

Challenge yourself to add value.

When you’ve been in your position for a long time, you may drift into "maintenance mode," Guzik cautions. "You develop your policies, your procedures, your standards. You educate; you communicate. Then once that’s accomplished, you hit a plateau," she says.

"The most important thing is not to be satisfied sitting on top of that plateau. It becomes comfortable; but when you become comfortable you become vulnerable." Instead, you need to be creative and innovative, and set new goals — even in a cost-cutting environment, Guzik says. "The business world today demands that we do more with less across the board," she says.

Take the time to build relationships

Do you want to know more about the hospital’s finances and how your work affects the bottom line? Or understand more about legal ramifications of what you do? Invite someone from finance or the legal department to lunch, or just ask him or her for a few minutes of his or her time to talk. "Take the opportunity to have lunch with people in your organization. Don’t go to lunch with the same people day after day," Guzik advises.

You also should find people who share your goals and can help you promote your programs and proposals, says Pat Dalton, RN, COHN-S, occupational health project specialist at Pitt County Memorial Hospital in Greenville, NC.

She has been in occupational health nursing for 36 years. "You’ve got to have an ally, somewhere along the line. It might be a physician. It might be a new medical director. It might be the chairman of infection control or safety or risk management."

For example, when Dalton wanted to establish an alternative staffing program for nurses on work restrictions, she first went to the vice president of nursing with her idea and gained support. Eventually, she and the vice president presented the idea to top administration and the hospital’s board. Don’t work alone, she advises. But make sure you bring your proposals to people who have the power to make them happen. "You can’t do things in a big way unless you start at the top and know your support comes from there," she says.

Boost your skills.

At Inova Health System in Fairfax, VA, employee health is a part of human resources.

Diane Dickerson, RN, MS, COHN-S, CPHR, director of Employee Occupational Health Services, wanted to understand the human resource perspective, so she earned a master’s degree in human resource management and development.

"I wanted a broader scope or a broader knowledge of the scope of HR and how all the puzzle pieces have to fit together," she says. You’re not looking at [just] one person’s needs, you’re looking at a whole organization."

The degree didn’t lead to an immediate raise, but Dickerson eventually was promoted from employee health manager to director.

If you want to know more about another area, such as budgeting, don’t wait for your hospital to send you to a seminar, Guzik adds. "We have to be motivated to do those things on our own — otherwise, you are not perceived to be professional and motivated to change yourself. We have to take the initiative to continue to learn, continue to grow, to move beyond our comfort level so we can speak the language of other people in the organization."

Market yourself.

Do your employees think of you as a trusted professional who’s there for them? Do your administrators know what you do and how you work to prevent injuries and lower costs? They will if you make them aware of accomplishments.

Strode enjoys building relationships with employees and going beyond regulatory compliance or injury surveillance. "I always think of the employees as my patients. I want them to know I’m here for their health," she says.

Strode also advises employee health professionals to get out the word, for example, by putting articles on employee health in the hospital newsletter.

"We’ve been trying so hard to empower our nurses. Publicize yourself and all that you do," she adds.